Oral Medicine in the Elderly Flashcards
What oral conditions can affect the elderly?
- lichen planus
- mucous membranes pemphigoid
- herpes zoster
- post herpetic neuralgia
- carcinoma
what are the main conditions you may see in elderly patients?
- denture related problems
- dry mouth
- drug reactions
- trigeminal neuralgia
- herpes zoster and post-herpetic neuralgia
- burning mouth syndrome
- oral cancer
What occurs if a haemangioma is nicked during treatment?
Excessive bleeding
How are haemangiomas treated?
Cryotherapy in an oral surgery hospital setting
What is a fibroepithelial polyp?
Not sinister! Just annoying
- caused by trauma (eg sharp tooth/crisp)
- excess production of tissue forms lump!
How is a fibroepithelial polyp treated?
Cut out of mouth
What is black hairy tongue?
Non sinister!
- quite often in smokers (pipes)
- overgrowth of normal surface of tongue that easily picks up stains!
How to treat black hairy tongue?
Really ensure tongue surface is cleaned well when brushing
What is geographic tongue?
Not sinister!
- areas of atrophy on the tongue
- 10% of people have this
- can cause sensitivity against spicy foods
What is atrophic glossitis?
Extremely smooth tongue caused by a lack of haematinics (iron, vit B12, folate)
What is frictional keratosis?
Not sinister!
- white patch caused by trauma
- layers of keratin deposited to try and protect area
What is speckled leukoplakia?
Can be sinister!
- found in angle of mouth
- speckled appearances should always be monitored because can develop into cancer
- premalignant lesion
- biopsy
- common in smokers
What is sublingual keratosis?
Thick white patch found on ventral surface of tongue
- ventral is a high risk site for oral cancer
- refer to oral medicine
What is traumatic keratosis in denture patients?
ill-fitting denture causes friction trauma
What is denture induced hyperplasia in denture patients?
Excess of mucosa deposited due to rubbing of ill fitting denture
- looks like an extra flap of skin/gum
What is denture induced stomatitis?
Fungal candida infection
Caused by:
- poor oral and denture hygiene
- leaving denture in 24/7
What is angular cheilitis?
Mix of bacteria & fungal infection of mouth
- usually caused by denture being a reservoir for bacteria & fungi
How can angular cheilitis be treated?
- ensure denture is cleaned well
- excessive OVD causes skin to fold over and harbour bacteria/fungi
- sagging skin can cause this
how can xerostomia be treated?
- change medication
- salivary replacement
- salivary stimulants
what is xerostomia?
dry mouth
what are examples of salivary replacements?
- saliva orthana
- bioxtra
what are examples of salivary stimulants?
- chewing gum
- glycerine & lemon
Why is glandosane not suitable for patients with natural teeth?
very acidic!
What drugs can cause lichen planus or lichenoid tissue reactions?
- NSAIDs
- beta blockers
- diuretics
- oral hypoglycaemics
- statins
- antimalarials
- sulphonamides
What are the non-malignant uses for bisphosphonates?
- osteoporosis
- paget’s disease
- osteogenesis imperfects
- fibrous dysplasia
What are risk factors for development of MRONJ?
- extremes of age
- bisphosphonates
- concurrent use of corticosteroids
- long use of bisphosphonates
- invasive dental treatments
- denture trauma
- poor OH, perio, alcohol & tobacco use
What is post herpetic neuralgia?
Constant burning sensation in dermatomal distribution
- extreme suicide risk!
What treatments are used in patients with post herpetic neuralgia?
- antidepressants
- gabapentin
- carbamazepine
- TENS machine
